A Longitudinal Study of COVID-19 Sequelae and Immunity
Authors: Michael C. Sneller, Adriana R. Marques, C. Jason Liang, Joyce Y. Chung
Journal: Annals of Internal Medicine (2022)

Letters1 November 2022A Longitudinal Study of COVID-19 Sequelae and ImmunityFREEMichael C. Sneller, MD, Adriana R. Marques, MD, C. Jason Liang, PhD, and Joyce Y. Chung, MDMichael C. Sneller, MDNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (M.C.S., A.R.M., C.J.L.), Adriana R. Marques, MDNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (M.C.S., A.R.M., C.J.L.), C. Jason Liang, PhDNational Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (M.C.S., A.R.M., C.J.L.), and Joyce Y. Chung, MDNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (J.Y.C.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0331 SectionsAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: This initial report of our ongoing study was meant to be a building block for future studies. This is why we present CIs for our findings and associations, which allow the reader to rule out more extreme effects and help prioritize which research hypotheses to explore going forward. Our study has a relatively small sample size; however, our data are unique in using a wide range of prespecified diagnostic testing done in a population of participants who have had COVID-19 and a control group well-matched for age, sex, and preexisting medical conditions.In our analysis, participants whose symptoms resolved before enrollment were not counted in the PASC subgroup. However, it is difficult to contend that we misclassified such participants because there is no agreed-upon criteria for how long symptoms must persist to be considered PASC. It is true that participants' recollection of when their current symptoms began could be subject to recall bias. However, results from multiple protocol-defined diagnostic tests done on all participants regardless of past or current symptoms are not subject to recall bias and are a major strength of this study.Finally, we are conducting a longitudinal trial to help better define the sequelae of SARS-CoV-2 infection. We believe our protocol design is rigorous and was the only practical way to initiate this study in June 2020. Drs. Chambers and Beaudoin suggest that the main effect of reporting our initial results may be an exacerbation of stigma for those with PASC. This mischaracterizes our findings and intent. We believe that to withhold the reporting of observed associations between PASC and mental health conditions would have been inappropriate given that mental health symptoms can be present in persons with PASC and can cause substantial disability—and, importantly, that these symptoms are treatable. In addition, our results are supported by a recently published study of 3193 participants with COVID-19 that found that the presence of anxiety, depression, and perceived stress before infection with SARS-CoV-2 were all significantly associated with PASC (1).Reference1. Wang S, Quan L, Chavarro JE, et al. Associations of depression, anxiety, worry, perceived stress, and loneliness prior to infection with risk of post-COVID-19 conditions. JAMA Psychiatry. 2022. [PMID: 36069885] doi:10.1001/jamapsychiatry.2022.2640 CrossrefMedlineGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (M.C.S., A.R.M., C.J.L.)National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland (J.Y.C.)Disclaimer: The content of this article does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4905.This article was published at Annals.org on 1 November 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Longitudinal Study of COVID-19 Sequelae and Immunity: Baseline Findings Michael C. Sneller , C. Jason Liang , Adriana R. Marques , Joyce Y. Chung , Sujata M. Shanbhag , Joseph R. Fontana , Haniya Raza , Onyi Okeke , Robin L. Dewar , Bryan P. Higgins , Katie Tolstenko , Richard W. Kwan , Kathleen R. Gittens , Catherine A. Seamon , Genevieve McCormack , Jacob S. Shaw , Grace M. Okpali , Melissa Law , Krittin Trihemasava , Brooke D. Kennedy , Victoria Shi , J. Shawn Justement , Clarisa M. Buckner , Jana Blazkova , Susan Moir , Tae-Wook Chun , and H. Clifford Lane A Longitudinal Study of COVID-19 Sequelae and Immunity Laura C. Chambers and Francesca L. Beaudoin Metrics LatestKeywordsAnxietyCOVID-19MemoryPASCPsychiatry and mental healthQuality of lifeVaccines ePublished: 1 November 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.Loading ...